Low-temperature deposition of crystalline titania films on intrinsically bioinert materials to induce the bioactivity is of practical interest, not only because it meets the demand of providing organic biomaterials with bioactivity, which cannot tolerate high-temperature thermal treatments, but also because it reserves abundant Ti-OH groups facilitating the apatite deposition. In this paper, rutile films with thickness varied from 0.1 microm to 1.7 microm were deposited on commercially available pure titanium substrates from 1.5 M titanium tetrachloride aqueous solution kept at 60 degrees C for 3-60 h. The rutile films grew to give a preferred (101) crystalline plane in the X-ray diffraction pattern. After soaking in a simulated body fluid of the Kokubo solution (SBF) for 2 days, the rutile films with thickness over 0.6 microm were covered with a layer of apatite. All the films with various thickness induced apatite deposition in SBF after soaking for 5 days. The bioinert polytetrafluoroethylene (PTFE) was also found to exhibit remarkable in vitro bioactivity as to induce apatite deposition from SBF within 2 days, after depositing the rutile film on the surface.
Background
Chronic subdural haematoma (CSDH) is a common condition in the elderly that often requires neurosurgical management. For small CSDH, evidence has emerged that statins may reduce haematoma volume and improve outcomes, presumably by reducing local inflammation and promoting vascular repair. We wish to extend this evidence in a study that aims to determine the efficacy and safety of atorvastatin combined with low-dose dexamethasone in patients with CSDH.
Methods
The second ATorvastatin On Chronic subdural Hematoma (ATOCH-II) study is a multi-centre, randomized, placebo-controlled, double-blind trial which aims to enrol 240 adult patients with a conservative therapeutic indication for CSDH, randomly allocated to standard treatment with atorvastatin 20 mg combined with low-dose dexamethasone (or matching placebos) daily for 28 days, and with 152 days of follow-up. The primary outcome is a composite good outcome defined by any reduction from baseline in haematoma volume and survival free of surgery at 28 days. Secondary outcomes include functional outcome on the modified Rankin scale (mRS) and modified Barthel Index at 28 days, surgical transition and reduction in haematoma volumes at 14, 28 and 90 days.
Discussion
This multi-centre clinical trial aims to provide high-quality evidence on the efficacy and safety of the combined treatment of atorvastatin and low-dose dexamethasone to reduce inflammation and enhance angiogenesis in CSDH.
Trial registration
ChiCTR, ChiCTR1900021659. Registered on 3 March 2019, http://www.chictr.org.cn/showproj.aspx?proj=36157.
ᯑɛɉɇɻǽףᕮո╫Ǻȗș۰༔ǤțǮɳɉɳڽȂȪɒɇʀɄࢪɛكɉɇɻǽႹΚΧᙉ˛ǺǙǠȚȪəɇȬɐኝլTitania layers were deposited on titanium substrates in titanylsulfate solutions under varied concentration 0.01 and 0.03M, pH 0.67-1.27 and temperature 60 and 80c C. They were rinsed and subsequently aged in water at 80c C for 3d. The layers consisted of only rutile or rutile with trace anatase, depending on the conditions. The X-ray diffraction intensity indicates that the rutile particles grew preferably in 101 plane, regardless of being aged or not. When aged, the anatase diffraction intensity increased, and anatase newly grew in the layer consisting only of rutile. When soaked in a simulated body fluid SBF of the Kokubo recipe, the rinsed layer with only rutile was weakly active to deposit apatite within 5 d, while the other two exhibited no deposition. The aging improved activity. Although anatase is reported in the literature to be more active than rutile, the present study indicates that the rutile layer is more active. Thus, it is concluded that topotaxy or epitaxy would not work well but other issues like the presence of Ti-OH affect apatite deposition.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.